Election to participate in a County offered health plan will take place within the first 31 days following date of appointment to permanently allocated position of .49 FTE or greater or it shall be made during an annual open-enrollment period. Enrollment in vision and basic life insurance is automatic. Mid-year enrollment can only be permitted as allowed by IRS Section 125 or as required by HIPAA or other applicable regulations.
The effective date of benefits will be the first of the month following date of initial eligibility.
Health plan coverage will be paid on bi-monthly basis (24 payments per year).
18.2.1 County Offered Medical Plans
The County will offer at least one HMO plan and one plan permitting out-of-network provider coverage. No changes to existing medical plans will be made without completion of meet and confer with the bargaining units. The benefit provisions, co-payments and deductibles of each plan are outlined in the Summary Plan Description or Evidence of Coverage.
Specific reference to a vendor does not obligate the County to continue to offer a medical plan offered by a specific vendor. The County may change health insurance carrier(s) and/or network provider(s), provided the plan design(s) are substantially equivalent.
18.2.2 County Contribution Toward Active Employee Medical Benefits
Effective the pay period beginning September 11, 2018 for coverage beginning October 3, 2018, the County shall contribute up to a maximum of the following amounts based on level of coverage for employees enrolled in County–offered medical coverage for any eligible full-time regular employee and their eligible dependent(s).
This is the full and total contribution amount the County will contribute toward medical benefits for active regular employees and their dependent(s).
The County shall contribute to part-time eligible employees on a pro-rated basis, in accordance with Section 18.2.6.
18.2.3 Dental Benefits
The County offers dental and orthodontic benefits to full and part-time regular employees and their eligible dependent(s). Benefit provisions, co-payments and deductibles are outlined in the Summary Plan Description or Evidence of Coverage.
The employee contribution shall be $13.04 bi-monthly ($26.08 per month).The County shall contribute to part-time eligible employees on a pro-rated basis, in accordance with Section 18.2.6.
Effective the pay date of October 3, 2018, and continuing beyond the term of this MOU extension, the employee contribution shall be suspended, resuming October 1, 2020. The suspension of the employee contribution is contingent on Union ratification of the successor MOU and approval by the Sonoma County Board of Supervisors on or before September 25, 2018.
18.2.4 Vision Benefits
The County provides vision benefits to full-time active employees and their dependent(s), and computer vision care benefits to full-time active employees, with no employee contribution.
Part-time employees will automatically be enrolled in the vision benefit and the County shall contribute to part-time eligible employees on a pro-rated basis, in accordance with Section 18.2.8. Benefit provisions, co-payments and deductibles are outlined in the Summary Plan Description or Evidence of Coverage.
18.2.5 Life Insurance
The County provides a basic term-life insurance plan for an allocated full-time equivalent position of sixty (60) hours or more (.75 FTE or more) with no employee contribution. Effective May 24, 2016, the life insurance coverage amount will be an amount equal to one (1) times the employee’s base salary. Enrollment in basic life insurance is automatic, based on eligibility. Part-time employees who are regularly scheduled to work less than sixty (60) hours per pay period may purchase coverage through payroll deduction.
Each eligible and enrolled employee may purchase through payroll deduction dependent coverage of $5,000 for each eligible dependent. Benefit provisions are outlined in the Summary Plan Description or Evidence of Coverage.
Eligible employees may purchase additional life insurance coverage for themselves at their own expense upon initial eligibility or during the annual open enrollment periods specified in Section 18.2. Effective the first pay period following a special enrollment (June 21, 2016), the employee may purchase supplemental coverage in increments of $10,000, not to exceed the maximum of $500,000 which includes the County paid basic term life insurance plan and supplemental coverage purchased by the employee, in accordance with the insurance carrier’s policy. Members will be responsible for paying any increased cost for the benefits.
Participating employees and the County will be required to follow the insurance company’s contracted requirements with respect to maximum amounts and the necessity for evidence of insurability in order to be eligible to receive the benefit as may be amended from time to time and may be based on actual participation by County employees in the program. An employee enrolled in supplemental coverage who moves from one age bracket to the next higher bracket will have to pay the rate of the higher age bracket beginning the January of the year in which the employee moves to the higher age bracket.
Effective June 21, 2016 members enrolled in supplemental coverage who make no changes to their supplemental coverage during open enrollment will automatically have their supplemental coverage amount adjusted to the nearest, lower, multiple of $10,000 below current coverage. Members will be responsible for paying any increased cost for the benefits.
18.2.6 Part-Time Employee – Health Benefits
Part-time employees in allocated positions of thirty-two (32) hours or more biweekly (.40 FTE minimum) shall be eligible to participate in the County’s medical, dental and vision plans and the County’s contribution toward their premiums shall be pro-rated. Pro-ration shall be based on the number of paid status hours in the pay period, excluding overtime.
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